Breastfeeding and Pumping, Pumping, Pumping, Pumping, Pumping....

My mum coaching me through my first sucessful latch with Phoebe at 1 week old.

I have unresolved emotions about my breastfeeding experience and I think a lot of mothers do.  It’s not like I think about it all the time (I have moved on with my life!) but when I reflect on the first 3 months of their lives and my battle to breastfeed two premature babies I do get emotional.  

I had some obstacles to successful breastfeeding.  This is my list of “premature baby” breastfeeding issues:

• My babies were unable to suck until they were 3 days old
• They did not successfully latch until they were 7 days old
• My babies needed help latching for the several weeks (you have to kinda do it yourself, often several times!)
• My milk did not come in until they were 8 days old because I had to bring it in with an electric breast pump
• I only ever had enough milk to feed one baby even though I tried natural medicines, drugs, extra pumping, etc.
• I only had half an hour per child to change their nappy, breastfeed, burp, bottle top up, burp and resettle to sleep while they were in Special Care.
• I was only allowed to gradually increase breastfeeding from 1 feed a day to 5 feeds a day between 1 week and 3 weeks old.  Premature babies find breastfeeding absolutely exhausting and are really not up for breastfeeding around the clock.
• The first time they ever received all their feeds at the breast was at 3 weeks old and even then I could only offer the breast then top up with formula in a bottle because I didn’t have a good supply.

This is my list of “reflux baby” breastfeeding issues that presented at 7 weeks:

• Baby would scream and arch back mid feed
• Baby would quickly pull off (taking half my nipple with them!)
• I would cry every feed because it hurt me so much and it absolutely killed me to hear them scream in pain.

As I’ve mentioned in a previous post - my nipples were so badly damaged and I was so emotionally and physically drained that I gave up breastfeeding at 8 weeks.  I will always feel guilty that the day they developed reflux was the day I missed a pumping session (our first outing with our babies!) and they were given more formula than breast milk.  I know reflux can develop in breastfed babies but I also know reflux is more prevalent in formula feed babies.  I wonder if I had enough milk for both would they have gone through all that pain?

I then gave up pumping at 11 weeks because they developed RSV and were admitted back to hospital for a week.  This was extremely stressful for me and I had a baby lying on my chest 24/7 in an upright position so she could breathe.  I have written about this in a previous post about sick babies. I know what some of you are thinking..."why didn't she start pumping again when she got home?".  The thought did occur to me but honestly - they were very, very, very demanding babies and I was barely coping with the hours of crying as it was.  Maybe I could have tried to bring in my supply again at around 5 months?? Maybe??  But I tried to pop them on the boob and they'd already forgotten how to breastfeed and so I would've been pumping every 2-3 hours again and I did not enjoy that the first time!

I guess the point of this post is to let people know that breastfeeding twins is more than just trying to latch two babies at one time.  There are many obstacles to overcome that many people would be absolutely clueless about.

Overstimulation and Self Settling – 4 months

I could write sooooo much about our sleep journey so I will keep this post to what was happening in the girls’ life at 4 months old when we asked a “baby whisperer” to help us.  The girls had the following symptoms.

• A lot of crying (3-4 hours a day)
• Difficult to feed (bottle refusal and crying)
• Hard to settle to sleep (not even mummy rocking, patting, shushing, car, pram, music, etc.etc. would work!!!  They would just scream for hours and then pass out from exhaustion)

Here was the baby whisperer’s diagnosis:

• Overstimulated.
• Overtired.

Recommended routine for when they are awake:

• Baby wakes and then nappy change. 
• Put baby in bouncer and leave them alone.  Don’t be stimulating.
• Wait for baby to tell you they’re hungry.  It’s important to learn your baby’s hunger signs....most babies grizzle and try to eat their fists.
• Offer food.  Don’t beat yourself up if they don’t take much.  You can’t make a baby drink!
•  Burp lots
• Put them back in the bouncer and leave them alone.  Don’t be stimulating.
• Wait for them to tell you they are tired.   Tired signs are very important and shouldn’t be ignored.  Tired signs may include grizzling, jerky limb movements and yawning. 
• Offer food again.  This was to make sure they were full before putting them back to bed.  This was important with my girls who would often refuse to feed at all during an awake period.
• Put baby to bed.  

Controlled comforting:

• Put baby to bed and give them a sleep cue such as “sleep time”, “shhh” or a song – whatever you are willing to do over and over (you’ll see why soon...!).  Put your hand on their back (mine were tummy sleepers) and give them a reassuring soft pat/jiggle to calm them down a bit while giving the sleep cue.  At this point they may be protesting but hopefully not screaming.
• Leave the room and listen.

-          Now you want to listen and let the baby protest but not let them get hysterical.  This is a hard judgement to make, especially by mums who are particularly sensitive to their baby’s cries!  This is where having a baby whisperer there to hold you back from running in is helpful!  The idea is not to help them to sleep by going in as soon as they start crying....the idea is to let them cry but intervene before they get so upset it is really hard to calm them down.

• Give the sleep cue and calm baby down without picking them up.  You want to hang around long enough to calm them down but not aid them to sleep. 
•  Leave the room and listen.
• Repeat until baby is asleep.

We had a rule that we would let baby have their dummy the third time we went in.  Often they would settle at that point.  It was strange that they wouldn’t settle if we put them in the cot with the dummy straight away but letting them cry a bit before the dummy worked well. 

I am not a Robin fan either – Twins with Reflux

So here is my post about reflux.  At about 8 weeks my girls started to get more and more difficult to keep happy.  They would take longer and longer to settle to sleep.  Then they would cry a lot after feeds.  Then they would cry a lot during feeds.  In a week they had gone from fairly contented babies to babies who seemed to cry in pain at most feeds.  When I say cry I don’t mean a bit of “boo hoo, I’m hungry”  I’m talking “AHHHHHHHHHHHHHHHHHHHHHH I’m in a HUGE amount of pain!!!!!!!!!!!!!!!!!!!!!!!!!!!!!” high pitched squeal that got the attention of our neighbours and made me cry, stress and lose my sanity. 

I, of course, consulted a baby book that had a large section of baby crying – “Baby Love” by Robin Barker. 
From this book I got the general gist that:

• Babies cry and sometimes they cry for hours so just deal with it,
• colic is a myth and reflux is over diagnosed – your baby couldn’t possibly have either of these, and
• bothering your GP with “my baby is crying” makes you look stupid and wastes their time.\

Of course she didn’t actually say those things but that was the general impression I got in my crazed sleep deprived, thereissomethingwrongwithmybaby and I’mabadmother kind of state.

It frustrates me that no one told me about silent reflux.  It is very common with preemie babies and is really obvious when you know that crying during and after feeding is NOT normal. To cut a long story short it turned out that the girls needed hypoallergenic formula and reflux medication.  However, it took three weeks for us to work this out and get the dose right.  There is really nothing quite as soul destroying as babies crying in intense pain and feeling completely helpless.  Reflux pretty much pushed me close to depression.  If it wasn’t for my faith in God I believe I would’ve developed post natal depression.  I was so close so many times but my faith and my unbelievable husband, family and friends kept me from........ who knows what.

I believe the girls developed an aversion to milk and this is why they didn’t drink a full bottle of milk until they were 12 months old.  I also blame reflux for their poor sleep quality for several months.  It is also the reason why I had to stop breastfeeding and eventually, pumping.  Imagine trying to feed a screaming child that once latched on quickly pulls off (taking half your nipple with them!), arches her back and screams in even more pain.  My nipples were so badly damaged and I was so emotionally and physically drained that I gave up breastfeeding at 8 weeks and pumping at 11 weeks.

I will always feel guilty that the day they developed reflux was the day I missed a pumping session and they were given more formula than breast milk.  I know reflux can develop in breastfed babies but I wonder if I had enough milk for both would they have gone through all that pain?